Individual
MARK A. HENLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
601 CHILDRENS LN, NORFOLK, VA 23507-1910
(757) 668-7456
(757) 668-9255
Mailing address
PO BOX 79137, BALTIMORE, MD 21279-0137
(757) 668-7200
(757) 668-9691
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0101045119
VA
2080N0001X
Neonatal-Perinatal Medicine Physician
0101045119
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006722610
—
VA
05
—
745611500
—
MD
05
—
7905636
—
NC
Enumeration date
05/22/2006
Last updated
12/09/2009
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